A Sunday Health Care Viewer's Guide

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Although Dems believe they’re close to their own net-cutting ceremony, the moment of victory will be a lot less clear than the last minute of a tourney game.

Updated at 7:05 AM EST on Sunday, Mar 21, 2010

As the NCAA basketball tournament reminds us, there’s nothing quite like a nothing-but-net, buzzer-beating, three-point shot that gives one team a climactic, decisive win as the crowd goes wild.

But although Democrats believe that they’re close to their own net-cutting ceremony — namely, the signing of a sweeping overhaul of the nation’s health insurance system — the precise moment of victory will be a bit less clear than the final moments of a tournament game.

On Sunday afternoon, the House of Representatives is expected to hold a climactic vote on the Senate-passed version of the health care bill. The vote will determine whether or not the president signs into law legislation that overhauls the way that Americans buy and keep their health insurance. If Democrats get the 216 “yes” votes they need to pass the bill — and they appear optimistic that they will — they will trumpet the passage of the legislation as a victory for the ages.

But the bill that the president will sign contains some unpopular measures, including special benefits for individual states like Nebraska. Both the House and the Senate must act to scrub those provisions to end up with a final product that most Democrats can tolerate.

(The Senate’s version of the health overhaul is so unpalatable that House Democratic leaders originally planned to try to approve the bill indirectly, with members voting on a measure to merely “deem” it passed. But the strategy came under heavy GOP criticism, with some even questioning its constitutionality, and the plan was nixed in favor of a direct vote on the Senate bill.)

The House is now expected to hold a series of votes Sunday, with debate starting after the body is gaveled into session at 1 p.m. EST.

The first vote, expected to take place around 3 p.m. EST, will be on a “rule” dictating the parameters of debate on the bill.

Later on Sunday, the House will vote on the “reconciliation” package, a series of “fixes” to correct problems in the bill passed by the Senate on Christmas Eve in 2009.

Those fixes must be approved by the Senate before they can take effect. Senate Majority Leader Harry Reid sent a letter to House Speaker Nancy Pelosi on Wednesday pledging that his caucus would vote to approve the corrections, which require 51 votes for approval, but Republicans may be able to derail that process.

The big moment for House Democrats will be Sunday’s final vote to approve the Senate-passed bill. If there are 216 “yes” votes or more, the bill will go to the president’s desk to be signed and enacted.

That moment will be as close as Democrats will get to their own version of the NCAA’s “One Shining Moment,” but there will be another tough game in the Senate before a real victory dance can take place. Even if the president signs the overhaul into law, there’s still work to be done in the Senate as that chamber works to approve the “fixes” initiated by the House.

Here’s the key rule of reconciliation that Republicans think they may be able to use to derail the fixes package in the Senate. Under the Senate’s “Byrd Rule,” named after its author Sen. Robert Byrd, D- W.V., any senator can raise an objection (called “a point of order”) to any part of the reconciliation bill that does not address budgetary matters. The extraneous matter would be removed from the bill if the parliamentarian upholds that point of order. Sixty votes would be needed to overturn that decision.

Republicans believe they have identified several key provisions that could be vulnerable to this rule. The result could be legislation that is the policy equivalent of Swiss cheese, with major pieces missing.

If a single word of the reconciliation bill is changed in the Senate, the bill will have to go back to the House and approved again.

And Republicans think that’s a real possibility. “If those people think they’re only going to vote on this once, they’re nuts,” said Sen. Orrin Hatch, R-Utah, in an interview with Bloomberg.